Department of Endocrinology, La Rabta university hospital, Faculty of medicine, University of Tunis-El Manar, Tunis, Tunisia.
Department of Oto-Rhino-laryngology, La Rabta university Hospital, Faculty of medicine, University of Tunis-El Manar, Tunis, Tunisia.
Endocrinol Diabetes Metab. 2023 Jul;6(4):e434. doi: 10.1002/edm2.434. Epub 2023 Jun 16.
Several ultrasound scoring systems have been developed to stratify the risk of malignancy of thyroid nodules, including ACR (American College of Radiology) and EU (European) TI-RADS. This study aimed to assess the diagnostic performance of these two classifications using histology as a reference standard.
It was a single-centre, retrospective study including 156 patients who underwent thyroidectomy. Ultrasound data of 198 nodules (99 malignant nodules and 99 benign nodules) were analysed. Both classifications were applied for all nodules.
Ultrasound criteria associated with malignancy were solid composition (OR=7.81; p < 10 ), hypoechoic character (OR=16.42; p < 10 ), irregular contours (OR=7.47; p < 10 ), taller-than-wide shape (OR=3.58; p = 0.02), microcalcifications (OR=3.02; p = .006) and the presence of cervical adenopathy (OR=3.89; p = .006). The prevalence of malignancy was 15.5%, 69% and 76.9% for EU TI-RADS categories 3, 4 and 5, respectively. It was 33.3%, 57% and 91.1% for ACR TI-RADS categories 3, 4 and 5, respectively. For category 5, EU TI-RADS and ACR TI-RADS had sensitivities of 60% and 41%, specificities of 82% and 96%, respectively. For categories 4 and 5 combined, the diagnostic performance of these two classification systems became comparable with a sensitivity of 89% and 86% for EU-TIRADS and ACR-TIRADS, respectively. The area under the ROC curve was 0.81 for the EU TI-RADS classification and 0.82 for the ACR TI-RADS classification.
EU TI-RADS and ACR TI-RADS scoring systems seem to be comparable in predicting malignancy in thyroid nodules.
已有多种超声评分系统被开发用于甲状腺结节恶性风险分层，包括 ACR（美国放射学院）和 EU（欧洲）TI-RADS。本研究旨在通过组织学作为参考标准来评估这两种分类方法的诊断性能。
这是一项单中心回顾性研究，纳入 156 名接受甲状腺切除术的患者。分析了 198 个结节（99 个恶性结节和 99 个良性结节）的超声数据。对所有结节均应用了这两种分类方法。
与恶性相关的超声标准为实性成分（OR=7.81；p<0.001）、低回声特征（OR=16.42；p<0.001）、不规则轮廓（OR=7.47；p<0.001）、高宽比>1（OR=3.58；p=0.02）、微钙化（OR=3.02；p=0.006）和颈部淋巴结转移（OR=3.89；p=0.006）。EU TI-RADS 3、4 和 5 类的恶性发生率分别为 15.5%、69%和 76.9%。ACR TI-RADS 3、4 和 5 类的恶性发生率分别为 33.3%、57%和 91.1%。对于 5 类，EU TI-RADS 和 ACR TI-RADS 的敏感性分别为 60%和 41%，特异性分别为 82%和 96%。对于 4 类和 5 类联合，这两种分类系统的诊断性能变得相当，EU-TIRADS 和 ACR-TIRADS 的敏感性分别为 89%和 86%。ROC 曲线下面积分别为 0.81 和 0.82。
EU TI-RADS 和 ACR TI-RADS 评分系统在预测甲状腺结节恶性方面似乎具有可比性。
